This data is covered under Rule Chapter 247 - Uniform Reporting System for Non-Claims Based Primary Care Payment. See Important Notes below for additional information.
November 12, 2024:It was brought to our attention by several payors as they prepare their systems for the new reporting requirements defined in 90-590 Chapter 247, Uniform Reporting System for Non-Claims Based Payments and Other Supplemental Health Care Data Sets, that the numbering scheme for data elements in Section 2. B, File Type NC, and File Type AC would be more efficient if MHDO retained the previous numbering version. We have made these revisions in Chapter 247 and can be found here. All previously approved requirements are red in Track Changes, and the new revisions to the numbering scheme are in orange. Notes have been added at the end of the NC and AC sections regarding these technical corrections made after formal adoption and will be incorporated into the rule when it is reopened for revision.
Payer Data Webinar Recording and Deck AvailableThe deck for the 3/6/23 webinar is available. Also the recording can be found on YouTube here: https://youtu.be/mhbWl6nvsPY. Note: Chapter 247 information begins 10:03 minutes in.
2/23/23 - Payer Data Webinar Scheduled for March 6th 2:00 - 3:00 pm ET
The MHDO Payer Data Portal collects and validates payer data required under both Rule Chapter 243: Uniform Reporting System for Health Care Claims Data Sets and Rule Chapter 247: Uniform Reporting System for Non-Claims Based Payments and Other Supplemental Health Care Data Sets. Maine Rule Chapter 247, which includes the collection of non-claims-based payments for primary care and behavioral health and aggregated, redacted claims-based payments for substance use disorder, was implemented in 2022 due to the requirements in LD 1196, now Public Law 2021, Chapter 603.
MHDO will host a webinar on Monday, March 6, from 2-3 PM ET to review the data submission and validation features of the MHDO Payer Data Portal, the resolution of common data submission issues and failures, and upcoming changes to Chapter 247. A recording of the webinar will be available for those who are unable to attend the session.
The purpose of the testing period is for submitters to test the new Chapter 247 file layout specifications and validation rules. All payers are required to participate in testing.
Follow these instructions for testing and see the recording of the portal demo.
07/13/22 - Follow-up Information from the June 30th WebinarPlease note the important tasks and dates below.
| Task | Start Date | End Date |
|---|---|---|
| Testing instructions and a recording of the portal demo will be emailed | 7/18/22 | 7/18/22 |
| Payer testing of data submission process in Payer Data Portal Test site | 7/18/22 | 9/12/22 |
| Begin submissions of 2021 data to Production Payer Data Portal site | 9/14/22 | 9/14/22 |
| 2021 data files and attestations are due | 10/7/22 | 10/7/22 |
The PowerPoint slides from the June 30, 2022 webinar are now available, as is the recording. The recording can be found on YouTube via this URL: https://youtu.be/hv-wgs4yT50 .
06/27/22 - Payer Data Webinar Thursday, June 30 from 1-2 PM ETThe MHDO is in the process of implementing Chapter 247, which includes the collection of Non-Claims-Based Payments and Aggregated, Redacted Claims-Based Payments. The collection of Non-Claims Based Payments for Behavioral Health and Aggregated, Redacted Claims-Based Payments for Substance Use Disorder is due to the new requirements in LD 1196, now Public Law 2021, Chapter 603. During the webinar, we will review Chapter 247 and demonstrate the file submission process. We will also review the timeline for testing and implementation.
Join the Webinar via Zoom Meeting:
The PowerPoint slides from the December 14, 2021 webinar are now available, as is the recording. The recording can be found on YouTube via this URL: https://youtu.be/BHqcthTLtlE.
12/14/21 - Webinar 12/14/21 to review the requirements and timeline for Chapter 247: Uniform Reporting System for Non-Claims Based Primary Care PaymentThe MHDO will be implementing the collection of non-claims-based payment data in 2022. A webinar will be held Tuesday, December 14, from 3:00 - 4:00 PM ET. During this webinar MHDO will review the requirements and timeline for Chapter 247 data. A recording of the webinar will be available for those who are unable to attend the session. Another webinar will be held in the spring of 2022 to review details of the submission process.
Join the Webinar via Zoom Meeting:
Please note these important tasks and dates for the submission of Chapter 247 NCBP Data.
| Task | Start Date | End Date |
|---|---|---|
| Payer webinar | Tue 12/14/21 | Tue 12/14/21 |
| Annual registration update information | Wed 2/2/22 | Mon 2/28/22 |
| Payer testing | Wed 5/18/22 | Fri 6/17/22 |
| Deploy changes to production | Tue 8/2/22 | Tue 8/2/22 |
| Submission of 2020 data | Wed 8/3/22 | Wed 8/31/22 |
Important Notes
MHDO is required by statute to create and maintain a useful, objective, reliable and comprehensive health information database that is used to improve the health of Maine citizens and to issue reports and or support the development of reports as mandated. The reason for proposing this new rule is so that MHDO’s data for Primary Care payments is accurate and comprehensive in that it reflects both payments made under the traditional fee for service model (governed under Chapter 243) and alternative payment models, which are non-claims based payments (governed under this proposed rule). PL 2019, Chapter 244 requires the Maine Quality Forum to develop an annual report to submit to the legislature on primary care spending in the state of Maine, using data from the Maine Health Data Organization. Currently, MHDO’s data set does not reflect the total investment that payors (both private and public) are making in primary care and therefore understates the level of spending in the state of Maine. This proposed rule provides the structure for the submission of data for non-claims based primary care payments. This will allow for accurate reporting and better inform future policy decisions specific to investments in primary care.
It is anticipated that this new rule will improve the accuracy of the State’s annual reporting of primary care spending in the state of Maine. The substance of the proposed rule is based on recommendations for uniformity in defining primary care and non-claims-based payments developed by Milbank Memorial Fund, in their report titled Measuring Non-Claims-Based Primary Care Spending. The rationale for adopting the Milbank methodology is to streamline the administrative burden for reporting entities and align with a strategy that may become the national standard adopted by the National Association of Health Data Organizations (NAHDO).